Don’t sit so close to the TV! – Myopia on the rise

Everyone has probably heard their parents tell them to not sit so close to the television. Is there any truth to this concern?

Our parents may not have been totally correct, but they were not completely wrong either. The prevalence of myopia continues to grow.

Why is Myopia increasing among children?

There are studies showing that the risk of myopia development and progression are not only due to hereditary/ genetics and ethnicity but also influenced by our environment and behavior. Having two parents which are myopic can increase the risk of developing myopia threefold or greater. "Although there is a genetic component in myopia development, the visual environment appears to be a major contributor to school-aged myopia." Children that spend less time outside and more time reading and on devices are more likely to develop or progress myopia.

What can be done to curb the risk of high myopia?  Taking breaks from focusing at near approximately every 30 minutes to look at distance may be one simple way to help reduce the risk of myopia progression.

Recently, newly designed daily disposal contact lenses have been FDA approved for myopia control. The treatment with these contact lenses has shown to control the progression of myopia and control axial length growth associated with the risk of high myopia (>5-6 diopters).

What treatments are available and which is best for me?

Careful monitoring of your child's vision development by an optometrist is critical in knowing when and what time of treatment may be appropriate. Current possible treatment may include one or a combination of the following:

1) Drops which temporarily open the pupil and limit the ability to focus. This is thought to slow the progression of myopia through interaction with some of the receptors in the eye that control eye growth.

2) Orthokeratology: Rigid gas perm lenses worn overnight to reduce nearsightedness by temporarily and reversibly reshaping the front surface of the eye (cornea).

3) Soft contact lenses with different zones of prescription work to control myopia progression.

4) Multifocal spectacles, to a lesser degree, have also been thought to help manage myopia progression.

5) Myopia Management Program by CooperVision uses a daily disposal contact lens, MiSight, to control myopia progression in children ages 8-12. The only FDA approved soft contact lens treatment to control myopia.

We are pleased to announce that we provide this new treatment in our office using MiSight daily disposal contact lenses available by CooperVision.  This treatment requires your child to use the contact lenses at least 6 days per week and at least 10 hours per day. Studies have shown an average 56% reduction in myopia progression and an average 52% reduction in axial length growth as compared to non-treatment.  We monitor axial length using A-scan biometry. This is a device used at our office to measure the length of the eye (axial length) using ultrasound.  The information gathered can help us determine the risk of developing myopia and the possibility of progressing to high myopia (>5-6 diopters) which can have long term implications in the health of the eyes. Development retinal thinning or detachment which can lead to permanent vision loss. Or having higher risk in developing glaucoma or cataracts.

MiSight Program

What can I expect on my first visit?

A complete exam will include:

1) Background: History to identify risk factors for myopia development and progression (parent history of myopia, age of onset of myopia, history of progression of myopia, history of past treatment of myopia)

2) Measure current prescription requirement

3) Evaluate the eye health

4) Measure the size of the eyes (axial length) and curvature of the front surface of the eyes.  This is a painless procedure.

5) Test new MiSight contact lenses

6) Train the patient on how to insert and remove contacts

7) Set up follow-up appointments for one week, one month, and 3-6 months out.

Can’t sleep at night? Let’s Discuss Blue Light.

Electric Blue - Illustration by Jason Aponte

It’s 2 A.M. and you are staring at your phone on your favorite social media app waiting for your body and mind to fall asleep.  This is a routine many of us follow, but what we do not realize is that this trend is creating a new problem.  Although the sun is the biggest source of blue light, our electronic devices and fluorescent bulbs give off this high-energy light as well. 

Studies have shown that the range of wavelength that is toxic to retina cells is 414-445nm.  Exposure to this range of wavelength of light, may be affecting our sleep and may be causing damage to our retinas.  In particular, it may cause macular degeneration, but another negative effect of Blue Light is how it affects our sleep patterns.  Our usage of digital devices is increasing and we need to find ways to protect our eyes.

There are a few ways of protecting your vision. 

• Reduce exposure and usage of electronic devices.  This may be difficult due to the increase of computers in the workplace.  Some electronic devices have the capacity to change your screen settings to reduce blue light.  There are also options of blue light filters that can be added directly onto your device. 

• When you are in the sun it is a good idea to wear a wide-brimmed hat.

• Lenses with built-in Blue Light Filters.  Here in the office of Dr. Ricardo Silva, we offer some of the best options that can be added to your glasses.

Not all blue light is harmful and there are some benefits to blue light, such as that it gives a positive boost to our mood.  If you are interested in creating your next pair of glasses with Blue Light protection, ask one of our professional staff about some of the lenses we provide such as Eyezen, Transitions, and Prevencia.

Dry eyes? Then why are my eyes tearing?

Illustration by Jason Aponte

Dry eyes can present itself with many different symptoms like burning, sandy gritty feeling, and blurred vision. It may sound like a complete contradiction, but sometimes tearing can also be a symptom of “Dye Eyes”. How can this be dry eyes if I’m tearing? There is a simple explanation to this riddle.

The tear is composed of three layers.

1.  The outermost layer is oil.
2. The middle layer is water.
3. The lowest layer on surface of the eye is mucous.

When the outermost layer is compromised, the oil is not sufficiently present, then the tear will evaporate or run out of the eye leaving the eye dry.  So what do I do if I have dry eyes?

The most important step is to have a routine eye exam to evaluate the health of your eyes. The optometrist can evaluate your tears and treat your dry eyes depending on which layer or layers are affected.

The oil layer is produced by glands found in the eyelids. The oils are released through tiny holes found just behind the lashes at the edge of the lids. The water layer is produced by the lacrimal gland located on the upper, outer portion behind the bone. And, the mucous layer is produced by cells on the surface of the eye. If the oil layer is affected then hot, moist compresses with massages may be necessary in order to drain stagnant oils from the glands. This technique should be taught by your eye doctor to avoid injury and to get the best results.

There may be an inflammatory reason to the dry eyes in which case Omega 3 supplements and decreasing Omega 6 consumption may help the tear composition. Medications like Restasis and Xiidra may be useful in combating dry eyes by decreasing the inflammatory response of the body, but require a written prescription by your eye doctor.

If you have visited your local drug store lately, I’m sure you have been overwhelmed by the number of lubricating drops on the shelves.  Why play the guessing game? Your eye doctor can help you find the right drops based on your specific dry eye problem. As dry eye disease progresses, all layers of the tear may be affected and damage to the surface of the eye can occur. Now that your education has begun about dry eyes and before you attempt any of these possible solutions, see your optometrist to determine the best treatment for your dry eye.